冠心病患者血清和肽素水平的检测及其临床意义  

Clinical significance of serum copeptin level in patients with coronary heart disease

作　　者：戎成振[1] 蔡鑫[1] 潘登月[2] 杨静静[1] 周桂建[1] 陈斌[3] 

机构地区：[1]蚌埠医学院第一附属医院心内科,安徽蚌埠233004 [2]安徽省阜阳市第二人民医院干部病房,236300 [3]江苏省连云港市第二人民医院心内科,222066

出　　处：《蚌埠医学院学报》2012年第2期168-170,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨和肽素(copeptin)与冠心病(CHD)的关系及临床意义。方法:将94例冠状动脉造影患者分为CHD(组71例)和对照组(23例);CHD组又分为稳定型心绞痛(SAP)组(20例)、不稳定型心绞痛(UAP)组(19例)和急性心肌梗死(AMI)组(32例)3个亚组;并根据Gensini积分,将CHD组分为轻度病变组18例,中度病变组24例,重度病变组29例;将AMI亚组分为AMI后并发心力衰竭组19例和AMI后无并发心力衰竭组13例。应用ELISA法测定所有患者血清和肽素水平。结果:CHD组患者血清和肽素水平明显高于对照组(P<0.01);AMI组和UAP组和肽素水平均明显高于对照组、SAP组(P<0.01);CHD重度病变组血清和肽素水平均高于对照组和CHD轻度病变组、中度病变组(P<0.01);AMI后并发心力衰竭组的和肽素水平明显高于AMI后无并发心力衰竭组(P<0.01)。结论:和肽素参与冠心病患者机体应激反应,反映冠心病病情发展的严重程度;和肽素与冠状动脉病变程度存在相关,对于冠脉事件的发生具有预警意义。Objective： To explore the relationship of serum copeptin level and coronary heart disease （CHD）, and its clinical significance. Methods：Coronary angiography （CAG）was performed in 94 hospitalized patients. According to coronary angiography findings, patients were divided into two groups ： CHD group（ n = 71 ）and non-CHD group as control （n = 23 ） ;the patients in CHD group were further divided into 3 subgroups： stable angina pectoris （ SAP, n = 20 ）, unstable angina pectoris （ UAP, n = 19 ）, and acute myocardial infarction （ AMI, n = 32） ; according to Gensini＇ s score, the CHD group were further divided into 3 subgroups ： mild stenosis group （ n = 18）, moderate stenosis group （ n = 24）, and severe stenosis group （ n = 29 ）. According to the AMI patients with heart failure （HF） or not, the patients in AMI group were assigned into AMI group with HF （ n = 19 ） and AMI group without HF （ n = 13 ）. Enzyme linked immunosorbent assay was adopted to detect the levels of copeptin from the serum of all patients. Results： Serum copeptin levels in CHD patients were significantly higher than those in normal control group （ P 〈 0.01 ） ; serum copeptin levels in AMI patients and UAP group were significantly higher than those in control group and SAP group （ P 〈 O. 01 ） ; serum copeptin levels in severe stenosis patients were higher than those in control group, mild stenosis group, and moderate stenosis group （P 〈 O. 01 ） ;comparing with AMI group without HF, copeptin levels in AMI group with HF were significantly higher（ P 〈0.01 ）. Conclusions ：Copeptin may be involved in stress response of patients with coronary heart disease,it may be correlated with the severity of coronary heart disease. Copeptin level is closely associated with pathology of coronary artery, it can warn the occurrence of coronary artery to happen.

关 键 词：冠心病 和肽素 急性心肌梗死 应激 诊断 

分 类 号：R541.4[医药卫生—心血管疾病]